Residency Program Outline
The resident rotations and the curriculum will be developed and coordinated by the CAMPEP-approved medical physics educational committee (MPEG), which will also be responsible for judging the competence of the resident in each area. The competency will be judged on the basis of CAMPEP program guidelines as well as interviews with the primary physicist in each area, interviews with the resident and performance on standardized and customized examinations.
Clinical Rotations
The Physics Residency Program consists of two years of full-time equivalent clinical training, with progressively increasing responsibilities under the supervision of qualified medical physicists. The program follows Report No 249: “Essentials and Guidelines for Clinical Medical Physics Residency Training Programs” published by the American Association of Physicists in Medicine (AAPM) in 2013 and the CAMPEP “Standards for Accreditation of Residency Educational Programs in Medical Physics”
Physics residents are immersed in the clinical environment throughout the Program. Upon completion of the program, the residents are expected to demonstrate competency in practicing fundamental clinical radiation oncology physics procedures and have a comprehensive understanding of all clinical topics in radiation oncology physics. The residents are prepared to pass all parts of the exams of the American Board of Radiology.
The Residency Program is divided into 9 core clinical rotations each with specific objectives and competencies that must be completed by the resident. Each rotation has a primary mentor that rotates throughout the faculty. The medical physics residency steering committee (MPRSC) reviews the rotation goals and objectives annually and determines whether changes need to be made. A description of the clinical rotation schedule is provided below.
UCSF Physics Residency Rotation Schedule
| Rotation | Topic | Time/Mentor | |
| Orientation | Employee Orientation, Introduction to Radiation Oncology Clinic, IT accounts, physics overview on clinical workflow, Record and verify systems, radiation protection, simulation, linac, warm-ups, MU calculations, chart checks, State and Federal regulations, professional guidelines, elements of professionalism, professional organizations, ethics, confidentiality and research on human subjects, environmental safety (HV, lead alloy) | 1 month | |
| 1 | Patient safety/ Patient specific measurements |
Special topics (hip prosthesis, pregnant patient, pacemakers, custom patient shielding), IMRT QA principles/applications of Failure mode effects analysis (FMEA) and Root cause analysis (RCA) In-vivo dosimetry (e.g. diodes, thermoluminescent dosimeters (TLDs), optically stimulated luminescence dosimeters (OSLDs) Standards for exchanging and developing electronic health records |
2 months |
| 2 | CT simulation & Treatment Planning |
CT Simulators (including quality control, safety and compliance tests) Treatment simulation techniques (e.g. patient positioning, immobilization) Immobilization devices Step-and-shoot and sliding window IMRT Treatment planning algorithms Monitor unit calculations/configurations (e.g. SSD setup, SAD setup, extended distance, off-axis and rotational beams) Beam modifiers (bolus, wedges, compensators) Tumor localization and International Commission on Radiation Units and Measurements (ICRU), target definitions [e.g. gross tumor (GTV), clinical target volume (CTV), and planning target volume (PTV) Normal tissue anatomical contouring 2D and 3D treatment planning IMRT/VMAT planning/optimization/QA Site-specific treatment planning Plan evaluation [e.g. dose-volume histogram (DVH). Conformity index, homogeneity index, biological evaluators) Treatment records Dose limits to sensitive structures Clinical applications of various radiation treatments 3D external beam treatment planning workstations Inhomogeneity correction algorithms Total body irradiation (TBI) Total skin electron therapy (TSET) |
4 months
|
| 3 | Linac & Treatment planning system commissioning |
Conduct system calibration, performance evaluations, and quality control, safety and compliance tests, including vendor specifications, under the supervision of a qualified physicist Megavoltage photons Megavoltage electrons Beam scanning systems External beam dose measuring systems Radiation detector and measurements, ADCL, Annual QA, TG51 Beam modeling and TPS commissioning Beam data acquisition/management Beam modeling Treatment planning system commissioning Validation of imported images |
4 months
|
| 4 | Radiation Protection and Shielding |
Sealed source storage/safety/protection Sealed source inventory/check-in/out procedures Sealed source packaging/transportation (e.g. Title 19 CFR) Calibration of sealed sources Exposure and contamination surveys Radiation signage Definition and reporting requirements for medical events Radiation safety of personnel during radionuclide therapy Patient release criteria following radionuclide therapy and radiation safety for the public Safety policies/procedures Compliance audits Occupational and public dose limits National and state regulations Radiation exposure to the public Shielding design (primary and secondary barrier calculations) Neutron shielding Facility radiation surveys Personnel dosimetry |
1 month
|
| 5 | Imaging |
Image registration, fusion, segmentation, processing Image-guided radiotherapy (IGRT) equipment/techniques [e.g. planar MV and KV imagers, cone beam CT, non-radiographic localization (e.g. ultrasound (US), surface camera, radiofrequency (RF) beacon tracking MRI, PET, CT, SPECT, US DICOM standards and DICOM in radiation therapy (DICOM-RT) PACS systems and Information acquisition from PACS/images Quality/maintenance of imaging workstations Evaluation of viewing conditions |
1 month
|
| 6 | SRS, SBRT & Motion Management |
Gamma Knife & linac-based SRS Small field planning/optimization/QA Small field dosimetry CyberKnife and linac-based SBRT including advanced treatment planning Motion management techniques Organ motion-corrected methods Inhomogeneity correction algorithms (including Monte Carlo) |
3 months
|
| 7 | Brachytherapy & Hyperthermia |
HDR, seed implant and IORT Brachytherapy treatment plans and QA Brachytherapy implants (temporary/permanent) Brachytherapy applicators, LDR, HDR Hyperthermia, HIFU, BSD2000 |
3 months
|
| 8 | Proton | Proton therapy technologies and clinical indications, Eye beam line, self study |
1 month
|
| 9 | Transition to Practice (TTP) |
Clinical Service with a physicist of the day (machine troubleshooting, weekly and Initial Chart Check) Record and verify systems Treatment record design/maintenance Network integration/management The roles of physics and information technology staff |
2 months
|
| Elective | Focus on research and clinical project, if the resident is in a good position to complete the core clinical rotations. | 2 months | |
| Total months | 24 months |